| NPI | 1912201211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: WA NT60605904) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC60196429) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2015-10-14 |